Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
Nutrition and Metabolic Diseases Research Center, Department of Nutrition, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Asia Pac J Clin Oncol. 2022 Feb;18(1):118-126. doi: 10.1111/ajco.13524. Epub 2021 Apr 14.
We aimed to assess the association between deficient levels of circulating vitamin D, dietary intake of vitamin D, calcium and retinol, and risk of colorectal cancer in an Iranian population.
In this retrospective case-control study that was conducted between 2012 and 2015, 278 first incident colorectal cancer cases (colon cancer = 103; rectal cancer = 175), and 278 sex and age matched healthy controls (HCs) were recruited. Serum 25(OH)D, dietary vitamin D, and calcium intake were assessed. Logistic regression was used to estimate the odds ratio (OR) between studied factors and colorectal cancer. Estimates of OR were calculated according to both bivariate analyses based on the matching factors and multivariate analyses, with additional adjustment for potential confounders.
A strong inverse linear dose-response association was seen between serum 25(OH)D and colorectal cancer (P for trend = .002). In comparison to serum 25(OH)D more than 40 nmol/L, lower serum concentrations were significantly associated with an increased OR of colorectal cancer. When analyzing anatomical subsites separately, lower circulating 25(OH)D was associated with higher OR for both colon and rectum cancers. Dietary vitamin D and calcium intake were not associated with colorectal cancer. Interaction analysis between serum 25(OH)D and the amount of calcium intake demonstrated that the lowest level of both factors was associated with an increased OR of colorectal cancer. The highest OR of colorectal cancer that was associated with lowest circulating 25(OH)D was stronger at the highest retinol intakes.
This study demonstrated an inverse strong association between 25(OH)D concentration and colorectal cancer in an Iranian population.
我们旨在评估伊朗人群中循环维生素 D 水平不足、维生素 D、钙和视黄醇的饮食摄入与结直肠癌风险之间的关系。
在这项 2012 年至 2015 年进行的回顾性病例对照研究中，共招募了 278 例首次确诊的结直肠癌病例（结肠癌=103 例；直肠癌=175 例）和 278 例性别和年龄匹配的健康对照者（HCs）。评估了血清 25（OH）D、饮食维生素 D 和钙摄入量。使用 logistic 回归来估计研究因素与结直肠癌之间的比值比（OR）。根据匹配因素的双变量分析和多变量分析，计算了 OR 的估计值，并且还针对潜在的混杂因素进行了额外的调整。
血清 25（OH）D 与结直肠癌之间存在很强的线性反比剂量反应关系（趋势 P 值=0.002）。与血清 25（OH）D 高于 40 nmol/L 相比，较低的血清浓度与结直肠癌的 OR 升高显著相关。当分别分析解剖亚部位时，较低的循环 25（OH）D 与结肠和直肠癌的 OR 升高均相关。饮食维生素 D 和钙的摄入量与结直肠癌无关。血清 25（OH）D 与钙摄入量之间的交互分析表明，两种因素的最低水平与结直肠癌的 OR 升高相关。与最低循环 25（OH）D 相关的结直肠癌的最高 OR 在最高视黄醇摄入量时更强。
本研究在伊朗人群中证明了 25（OH）D 浓度与结直肠癌之间存在强烈的反比关系。
